Surgical Management: Billroth I
The surgical treatment of peptic ulcer disease (PUD) has declined significantly in recent decades due to the advent of H. pylori treatment, acid-suppressing medications, and endoscopic therapies. Uncomplicated PUD can often be treated successfully with medical interventions. However, surgical management of ulcer disease still plays a role in refractory and complicated ulcer disease. The first large gastric resection with reconstruction was described by Theodor Billroth in 1885. In the following years, Dr. Billroth and colleagues conceived a number of surgical techniques for reconstruction following gastric resection. Among the most widely adopted and still used in practice today is the Billroth I gastroduodenostomy (B-I). The B-I procedure is a hemigastrectomy with gastroduodenostomy that restores the native configuration of the gastrointestinal tract. In this chapter we will discuss the indications, technique, management, complications, and expected outcomes of B-I reconstruction for PUD.
KeywordsPeptic ulcer disease PUD B-I procedure Gastroduodenal anastomosis Billroth I Laparoscopic gastroduodenal anastomosis Laparoscopic B-I reconstruction
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